Ethics of Quarantine: Society vs Individual

One notable example of a competing priority when the good of society is favored over the good of the individual is in the case of quarantines. In particular, the fear of an Ebola outbreak a few years ago led to some particularly public examples of individuals quarantined for reasons that they felt were not appropriate. A nurse who cared for Ebola patients in Africa, Kaci Hickox , was involuntarily quarantined upon her return back to the United States (Jobe, 2016). This quarantine was implemented despite CDC guidance that stated the quarantine was not necessary. It should be noted that politicians responsible for health related legislation may often have ulterior motives that may not abide by public or individual health ethics standards (Wynia,

2016). Ms. Hickox eventually was able to appeal the decision in state district court which ruled that a less restrictive environment was more appropriate, but only after she was already subjected to a quarantine for what she, and other health officials, considered an unnecessary period of time (Jobe, 2016).
Isolation, or the separation in some manner of patients that have an illness from others, has been viewed fairly consistently within the medical community and public as reasonable (Wynia, 2007). However, a quarantine is different in that is involves the separation of an individual who is by all accounts otherwise well. A quarantine by its nature is extremely restrictive in terms of individual rights. Another example of public health good being placed above individual rights was the quarantine in Taiwan during the recent SARS concerns. Over 130,000 were quarantined, and only 2 individuals were confirmed to have developed SARS. From a public health perspective, the ethical principal of non-maleficence, to first do no harm, can be used to justify a quarantine as the community and public would be the ones the ethical principle would wish to protect. However, from an individual professional’s ethical standpoint, a quarantine might violate the non-maleficence principle by harming the individual quarantined without adequate rational justification.
One example of when an individual’s rights are more important than public good is in the case of vaccinations and corresponding exemptions. Mandatory vaccinations have a clearly positive attributes from a public health perspective (Bayer, 2007). Mandatory vaccinations for school children to attend public schools have been widely implemented, however many individuals are now being granted exemptions for their children to not be vaccinated. A child with a low immune system or other complications related to vaccination clearly benefits from not being vaccinated. However, if the child were to contract the disease associated with the vaccine and infect others, it poses obvious dangers to the public. The individual rights of the parents in these cases to not have their child vaccinated are upheld over the public good that is clearly associated with everyone being vaccinated. In fact, outbreaks appear to be occurring with more frequency as more parents are deciding not to vaccinate.
Another example of an individual good being more important than the public good is in the case of expensive treatments for individuals who are unlikely to become well again, particularly if these funds arise from tax-payers.

These tax-payer funds would likely be much better utilized providing more effective, low cost care to more individuals than high cost, low effective care to one individual. However, as the provider follows medical ethics and their obligation is to the patient, this occurs quite frequently in our current system. This can happen in the treatment of cancers with low success rates, or other expensive treatments involved in prolonging life for individuals with terminal illnesses. Ultimately, future restrictions in resources and funding may require more difficult decisions based on the good of the many over the good of the individual.

References

Bayer, R. (2007). The continuing tensions between individual rights and public health. Talking Point on public health versus civil liberties. EMBO Reports, 8(12), 1099–1103. http://doi.org/10.1038/sj.embor.7401134

Jobe, K. M. (2016). THE CONSTITUTIONALITY OF QUARANTINE AND ISOLATION ORDERS IN AN EBOLA EPIDEMIC AND BEYOND. Wake Forest Law Review, 51(1), 165-188.

Wynia, M. K. (2007). Ethics and Public Health Emergencies: Restrictions on Liberty. The American Journal of Bioethics, 7(2), 1-5.

doi:10.1080/15265160701193559